Medicare: What You Need to Know

Overview

Medicare is health insurance that the United States government provides for people ages 65 and older. It also covers some people younger than 65 who have disabilities and people who have long-term (chronic) kidney failure who need dialysis or a transplant.

Medicare helps pay for most hospital services and doctor visits. It also helps pay for physical therapy, occupational therapy, and some other home health services.

But Medicare doesn't cover everything. It doesn't pay for:

  • Long-term care. This is different from short-term care to recover from an illness or injury.
  • Dental and vision care.
  • Dentures.
  • Hearing aids.

What are the parts of Medicare?

Medicare services are offered in parts. Parts A and B are often called original Medicare.

Part A

This covers hospital care, skilled nursing facilities for a limited time, and hospice. You can choose the doctors and hospitals you want, as long as they accept Medicare payments.

Part B

This part covers doctor visits and services such as wheelchairs, walkers, lab tests, and surgeries. It also covers preventive care, such as flu shots, mammograms, colorectal screenings, and yearly wellness visits.

Part C

Part C, also known as Medicare Advantage, is insurance run by private companies that have a contract with Medicare to provide Part A and B services. (You choose either original Medicare or Part C. You can't have both.) These plans usually offer extras not covered by original Medicare. Extras may include hearing, vision, and prescription drugs. Most insurance companies offer a Part C plan. These plans can vary widely in what they cover and how they are run. They can include HMOs, PPOs, fee-for-service, and medical savings accounts. You usually can use only the doctors and other providers allowed in the plan. Premiums, deductibles, and co-pays (costs that you have to pay to be covered) vary from plan to plan. Because there are so many Medicare Advantage plans, you may need to do a lot of research to compare them to find out which plan would be best for you.

Part D

This part covers prescription drug benefits. With original Medicare, you need to join a drug plan (run by a private company) and pay a monthly premium. With Medicare Advantage, drug coverage may be part of your plan. If not, you can choose to join and pay for a separate drug plan along with Medicare Advantage.

Information about Medicare: What You Need to Know

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff

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